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Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis

Overview of attention for article published in Critical Care, December 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (82nd percentile)
  • Average Attention Score compared to outputs of the same age and source

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Title
Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0739-6
Pubmed ID
Authors

Xin Zhang, Wei Xuan, Ping Yin, Linlin Wang, Xiaodan Wu, Qingping Wu

Abstract

IntroductionThe value of gastric intramucosal pH (pHi) can be calculated from the tonometrically measured partial pressure of carbon dioxide ( PCO2 ) in the stomach and the arterial bicarbonate content. Low pHi and increase of the difference between gastric mucosal and arterial PCO2 ( PCO2 gap) reflect splanchnic hypoperfusion and are good indicators of poor prognosis. Some randomized controlled trials (RCTs) were performed based on the theory that normalizing the low pHi or PCO2 gap could improve the outcomes of critical care patients. However, the conclusions of these RCTs were divergent. Therefore, we performed a systematic review and meta-analysis to assess the effects of this goal directed therapy on patient outcome in Intensive Care Units (ICUs).MethodsWe searched PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov for randomized controlled trials comparing gastric tonometry guided therapy with control groups. Baseline characteristics of each included RCT were extracted and displayed in a table. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes. Another measure of effect (risk difference, RD) was used to reassess the effects of gastric tonometry on total mortality. We performed sensitivity analysis for total mortality. Continuous outcomes were presented as standardised mean differences (SMDs) together with 95% CIs.ResultsThe gastric tonometry guided therapy significantly reduced total mortality (OR, 0.732; 95% CI, 0.536 to 0.999, P¿=¿0.049; I2¿=¿0%; RD, ¿0.056; 95% CI, ¿0.109 to ¿0.003, P¿=¿0.038; I2¿=¿0%) when compared with control groups. However, after excluding the patients with normal pHi on admission, the beneficial effects of this therapy did not exist (OR, 0.736; 95% CI 0.506 to 1.071, P¿=¿0.109; I2¿=¿0%). ICU length of stay, hospital length of stay and days intubated were not significantly improved by this therapy.ConclusionsIn critical care patients, gastric tonometry guided therapy can reduce total mortality. Patients with normal pHi on admission partially drive the ultimate result of this outcome; it may indicate that these patients may be more sensitive to this therapy.

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X Demographics

The data shown below were collected from the profiles of 13 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 24%
Other 5 15%
Student > Bachelor 4 12%
Researcher 3 9%
Student > Doctoral Student 2 6%
Other 6 18%
Unknown 6 18%
Readers by discipline Count As %
Medicine and Dentistry 15 44%
Engineering 3 9%
Agricultural and Biological Sciences 2 6%
Biochemistry, Genetics and Molecular Biology 1 3%
Immunology and Microbiology 1 3%
Other 5 15%
Unknown 7 21%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2022.
All research outputs
#4,645,258
of 25,371,288 outputs
Outputs from Critical Care
#3,194
of 6,554 outputs
Outputs of similar age
#70,341
of 395,411 outputs
Outputs of similar age from Critical Care
#265
of 466 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. Compared to these this one has done well and is in the 81st percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 395,411 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 466 others from the same source and published within six weeks on either side of this one. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.